Journal of Nursing and Public Health Research

Quality Improvement of Nursing Handover in a Trauma Unit, Uttaradit Hospital

2023-05-25T10:58:48+07:00

The objective of this study was to develop a quality improvement for nursing handover in a trauma unit, Uttaradit Hospital. This study used the FOCUS-PDCA continuous quality improvement process, which included nine steps: 1) identify a process to improve; 2) organize to improve the process; 3) clarify current knowledge of the process; 4) understand the source of process variation; 5) select the process improvement; 6) plan the improvement; 7) do the improvement; 8) check the results and act to hold the gain; and 9) make improvements continuously. The study also concurrently used the concept of the SBAR communication process, consisting of four steps: 1) situation; 2) background; 3) assessment; and 4) recommendation. The purposive sampling technique was used to select participants. Participants were 18 registered nurses from the trauma unit at Uttaradit Hospital, organized into two teams: three from the quality development team and 15 from the operations team. The research instruments were interview guidelines, an observation checklist guideline for nursing handover, and an incident report. Data were analyzed using descriptive statistics (frequency and percentages).

Results revealed that after applying the FOCUS-PDCA continuous quality improvement process and the SBAR communication process, registered nurses could correctly and completely perform more than 80% of the nursing handover protocol, and no incidents were found from nursing handover. Therefore, nursing administrators in other departments can apply this nursing handover development as a guideline to improve their nursing handover in order to continuously improve the quality of patient care

Development of a Clinical Nursing Practice Guideline for the Care of Neonatal Patients with Congenital Heart Disease Undergoing Systemic-to-Pulmonary Artery Shunt in the Neonatal Intensive Care Unit, Maharaj Nakorn Chiang Mai Hospital

2023-03-27T08:37:01+07:00

The objective of this research and development was to develop a clinical nursing practice guideline for the care of neonatal patients with congenital heart disease undergoing systemic-to-pulmonary shunts in the Neonatal Intensive Care Unit, Maharaj Nakorn Chiang Mai Hospital. The research process consisted of three phases: 1) guideline development; 2) guideline trials; and 3) evaluation and dissemination of the guideline. Participants were selected using a purposive sampling technique, consisting of four members of the guideline development team, 30 registered nurses working in the neonatal intensive care unit, and five infant patients undergoing systemic-to-pulmonary shunts. The research instruments were: 1) a clinical nursing practice guideline that was developed; and 2) the feasibility assessment form of the guideline implementation. The data were analyzed by descriptive statistics.

The results showed that the clinical nursing practice guideline (CNPG) included two main categories: 1) nursing care for the prevention of shunt occlusion and 2) nursing care for the prevention of pulmonary overcirculation. This CNPG was being evaluated by qualified experts according to the criteria of AGREE II with a score of 72 percent. The result after implementing this CNPG showed that no incidence of shunt occlusion or pulmonary overcirculation after the operation. Thus, this CNPG is effective in preventing shunt occlusion and pulmonary over circulation in infants, and other NICUs can apply this CNPG to prevent such complications.

The Effects of an Empowerment Program on Knowledge, Prevention Behaviors for Peritoneal Infection, and Peritoneal Infection in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis, Fang Hospital, Chiang Mai Province

2023-07-01T09:57:59+07:00

The objectives of this quasi-experimental study were to develop and examine the effects of an empowerment program on knowledge, prevention behaviors for peritoneal infection, and peritoneal infection rates in patients undergoing continuous ambulatory peritoneal dialysis at Fang Hospital, Chiang Mai Province. Participants were selected using a purposive sampling technique, consisting of seventy-six patients undergoing continuous ambulatory peritoneal dialysis, divided into experimental and control groups, with 38 participants in each group. The research instrument was an empowerment program on knowledge, prevention behavior for peritoneal infection, and peritoneal infection in patients undergoing continuous ambulatory peritoneal dialysis that was developed. Data collection instruments consisted of a socio-demographic form, a peritonitis assessment form, and a peritoneal dialysis knowledge and behavior assessment form. The data were analyzed using descriptive statistics. The independent t-test was used to compare the difference in scores of knowledge and prevention behavior for peritoneal infection between the experimental group and the control group after attending the program. The chi-square test was used to compare the peritoneal infection rate between the experimental group and the control group after applying the program.

The results showed that after receiving the program, the experimental group had statistically significantly more knowledge of continuous peritoneal dialysis than the control group (p-value < 0.001). The experimental group had statistically significantly better prevention behavior against peritonitis than the control group (p-value < 0.001). There was no incidence of peritonitis in the experimental group. Therefore, other health care provider teams can apply this empowerment program to promote knowledge, change self-care behaviors, and reduce peritonitis infection in patients undergoing continuous ambulatory peritoneal dialysis.

The Effects of Applying the 3-Plus Innovation to Eliminate Bed Sore on Reducing the Severity of Pressure Sores and the Satisfaction of Innovative Users in the Female Medicine Unit, Thabo Crown Prince Hospital

2023-06-07T13:29:45+07:00

The objectives of this quasi-experimental research with a one-group pretest-posttest design were to examine the effects of applying the 3-Plus innovation to eliminate bed sores on reducing the severity of pressure sores and the satisfaction of innovative users in the female medicine unit, Thabo Crown Prince Hospital. Participants were selected using a purposive sampling technique, consisting of 34 patients with pressure sores, aged 15 years and over and having a Braden Score less than or equal to 16 points. The research instrument was the 3-plus innovation to eliminate bed sores, consisting of gel mattresses, orthopedic pillows, and clothes to support the patient. The data collection tools were the pressure sore surveillance assessment form with a consistency index of 0.76 and the innovation satisfaction assessment form with a Cronbach's alpha coefficient of confidence of 0.81. The data were analyzed using descriptive statistics and the Wilcoxon Signed-Rank test.

The results showed that after applying the 3-Plus innovation to eliminate bedsore, the pressure ulcer severity of the patients decreased at a statistically significant level of 0.01. The average satisfaction score of innovative users was at a very good level in six aspects, namely prevention of pressure sores, minimization of violence, economics, and safety, as well as wanting to continue using the innovation and wanting to take it back to use at home. Therefore, health care teams can apply this innovation to care for patients with pressure sores both in the hospital and at home, as well as expand the results to be used in sub-district health promotion hospitals to reduce the number of patients with pressure sores.

The Development of an Operation Model for Village Health Volunteers in Collaboration with the Lee District Public Health Office in the Area Transferred to the Lamphun Provincial Administrative Organization

2023-06-29T09:41:29+07:00

The objective of this action research was to develop an operation model for village health volunteers in collaboration with the Lee District Public Health Office in the area transferred to the Lamphun Provincial Administrative Organization. The research process consisted of five steps: 1) situation analysis; 2) developing the model; 3) improving the model; 4) evaluating the model; and 5) presenting the model. Participants were selected by purposive technique, including the model development team, which included a researcher, representatives from the provincial public health department, representatives from the Provincial Administrative Organization District Public Health, the Administrator of Na Sai Subdistrict Health Promoting Hospital, representatives from the Na Sai Subdistrict Administrative Organization, the village headman, the village health volunteer president, and public health academics, totaling 10 people, and the working team, which included 112 village health volunteers in Na Sai Subdistrict. The research instrument was an operation model for village health volunteers that was developed. The collection data tools were a group discussion interview form to analyze the situation, an evaluation form of the model, and a satisfaction assessment form after using the model. Quantitative data were analyzed using descriptive statistics, including the mean and standard deviation. Qualitative data were analyzed using content analysis.

The results showed that an operation model for village health volunteers had three important elements: 1) coordination and command of public health work; 2) benefits and wages of village health volunteers; and 3) developing the potential of village health volunteers. Evaluation of the development of the model found that overall the mean was at a high level (Mean = 4.27, S.D. = 0.30). Evaluation of satisfaction found that village health volunteers were satisfied at a high level (Mean = 3.79, S.D. = 0.68). Therefore, health personnel can use this model as a guideline to promote the performance potential of village health volunteers under the policy of transferring to the Provincial Administrative Organization.